Discrimination a reality for most female surgeons

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More than half of female surgeons have faced or witnessed discrimination in the workplace, with orthopaedics was seen as the most sexist of all the surgical specialities, a UK survey found.

The researchers were from Imperial College Healthcare NHS Trust, University of Sunderland, Sunderland Royal Hospital, University College London Hospital NHS Foundation Trust, Hepatobiliary-Pancreatic Surgical Services Royal Infirmary of Edinburgh, University of Edinburgh and Imperial College London.

According to a South Wales Argus report, a confidential poll found the majority of female surgeons in the UK felt the sector was “male-dominated”, with nearly six-in-ten reporting or witnessing discrimination against women in the workplace. The research also found that about a fifth of female surgeons felt there was a “tangible glass ceiling”.

Orthopaedics was seen as the most sexist of all the surgical specialities, the responses showed.

The report says the poll was commissioned by the Association of Surgeons of Great Britain and Ireland (ASGBI) and distributed through its women in surgery Facebook page and Twitter for two weeks in October 2017. The majority of the ASGBI group was mainly made up of women, with around 70% of its surgeons coming from the UK but it also included doctors from India, Pakistan, US, Europe and Africa.

Researchers analysed the responses of 81 female surgeons to an online survey about their perceptions and experiences of working in the sector, what obstacles they had faced in their careers, and what they thought would help to overcome these. It found that 88% of female surgeons felt surgery remained male-dominated, with 59% reporting or witnessing discrimination against women in the workplace.

Despite women making up over half of medical school entrants in the UK, less than a third opt for a career in surgery, researchers said.

The research team found several perceived barriers to a surgical career for women, including poor work-life balance, inflexibility over part-time careers, gender stereotyping, and lack of formal mentorship.

Half the respondents said that motherhood and childcare commitments are the greatest obstacles for women wanting a career in surgery. While there is support for mums working in surgery, women are “presumed to deskill during maternity leave and are discouraged from working part-time”, researchers said. With fewer women represented at senior level, this could reinforce the idea that surgery is a male-dominated environment, they added.

Nearly a third of respondents said that sexist language should be challenged, while other suggestions for tackling discrimination included removing the stigma of career breaks for women, more flexible training and career options, and improved understanding of the impact of childcare responsibilities on working life.

The report says the researchers stressed that the study is based on a small online survey and so might not be representative of the female surgical workforce. But they said the poll nevertheless “illuminates the lived realities of female surgeons in the UK today”.

Abstract
Objective: Surgery remains an inherently male-dominated profession. The aim of this study was to survey women working within the discipline, to understand their current perceptions, providing insight into their practical day-to-day lives, supporting an action-oriented change.
Design and setting: The link to a confidential, online survey was distributed through the Association of Surgeons of Great Britain and Ireland (ASGBI) social media platforms on Facebook and Twitter over a 2-week period in October 2017.
Participants: Women working in surgical specialties and actively responding to the link shared through the ASGBI social media platforms. No patients were involved in the study.
Primary and secondary outcome measures: Data were analysed through a mixed-methods approach. The quantitative data were analysed through descriptive statistics and qualitative analysis was undertaken using a constant comparative analysis of the participants’ comments, to identify salient patterns (themes).
Results: A total of 81 female participants replied (42% response rate based on the Facebook group members), with 88% (n=71) perceiving surgery as a male-dominated field. Over half had experienced discrimination (59%, n=47), while 22% (n=18) perceived a ‘glass ceiling’ in surgical training. Orthopaedics was reported as the most sexist surgical specialty by 53% (n=43). Accounts of gendered language in the workplace were reported by 59% (n=47), with 32% (n=25) of surveys participants having used it. Overall, a lack of formal mentorship, inflexibility towards part-time careers, gender stereotypes and poor work–life balance were the main perceived barriers for women in surgical careers.
Conclusion: These findings highlight the implicit nature of the perceived discrimination that women report in their surgical careers. The ASGBI acknowledges these perceptual issues and relative implications as the first of many steps to create an action-oriented change by allowing all staff, regardless of gender, to reflect on their own behaviour, perceptions and the culture in which they work.

Authors
Maria Irene Bellini, Yitka Graham, Catherine Hayes, Roxanna Zakeri, Rowan Parks, Vassilios Papalois

South Wales Argus report
BMJ Open abstract


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